Date of Graduation

8-15-2009

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Judy Ortiz MHS, MS, PA-C

Second Advisor

Rob Rosenow PharmD, OD

Third Advisor

Annjanette Sommers MS, PA-C

Abstract

Background: Obesity, and therefore diabetes, is an ever growing problem in worldwide healthcare. As weight loss is critical in controlling blood sugar levels, more patients are turning to bariatric surgery after failing conventional weight loss methods. Gastric bypass, as the most commonly performed bariatric surgery, has been shown to be effective in glycemic control and even diabetes resolution. Laparoscopic adjustable gastric banding, however, is becoming more prevalent and its effects on diabetes and serum glucose levels have not been studied as extensively as gastric bypass.

Hypothesis: LAGB is an effective method of glycemic control in obese, diabetic patients. Study Design: Exhaustive search of available medical literature.

Methods: Literature search of Medline OVID, CINHAL, and WebScience using the keywords “gastric banding”, “diabetes”, “impaired glucose tolerance”, and “glucose control”.

Results: All studies confirmed LAGB is effective in weight loss and glycemic control with a majority of patients achieving diabetes resolution one year post surgery.

Conclusion: LAGB should be considered as a treatment for obese diabetic patients. Preliminary evidence suggests consideration for pre-diabetics and patients below the NIH recommended guidelines of BMI ≥40 or ≥ 35 with co-morbidities should also be considered as a preventative measure.

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